Redefining Recovery From Gambling Disorders: The Iowa Gambling Treatment Program

In the public health and recovery arena, there has been a shift in how mental health professionals understand how to best help those who want treatment for gambling disorders. As a guiding principal of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services, the principles of “recovery-oriented systems of care” are redefining treatment methods for behavioral health agencies. Thanks to Mark Vander Linden, executive officer for the Iowa Gambling Treatment Program, and his team at the Iowa Department of Public Health, this new definition of recovery is providing a new framework to help those with gambling disorders across the state. Their collective efforts serve as a model for public health officials about how to collaborate with key stakeholders to make sure the needs of a community are met in terms of problem and pathological gambling recovery services.

According to Vander Linden, a recovery-oriented system of care is “not a brand new concept, but is a rethinking of how to organize services that the state provides to problem and pathological gamblers.” This approach to treatment is person-centered and self-directed, allowing the individualto rely on their strengths and build on the resilience of their family, community and other support systems.

“In recovery-oriented systems of care, patients are encouraged to take responsibility for their own health,” said Vander Linden. “It also helps eliminate the obstacles that stand in their way, some being very tangible problems.”
Research shows that only 12 – 15 percent of those diagnosed with pathological gambling seek formal treatment. Common barriers to following through with treatment include the inability to afford treatment due to a lack of money or health insurance, a lack of access toresources and ambivalence about changing problematic behavior.

After a comprehensive evaluation of their services in 2011, the Iowa Gambling Treatment Program determined that implementing a recovery-oriented system of care required them to increase the tools and resources for clinicians and the general public. “We wanted to expand the view of what ‘treatment’ looks like for these individuals,” said Vander Linden.

One way that Iowa is accomplishing this goal is through their recovery support services program, which includes a broad array of community-based resources designed to enhance the client’s recovery. For example, some who struggle with pathological gambling also experience unmanageable debt. Iowa’s recovery support services menu includes housing assistance so a patient can keep utilities running at their residence and gas cards to help them travel to counseling appointments. The Iowa Gambling Treatment Program also offers Electronic Recovery Support Messaging, which sends encouraging and informative emails to the person in recovery to help improve their health, life quality and wellness.

Iowa’s shift to a recovery-oriented system of care required the collaboration of key players throughout the state. In 2011, the Iowa Department of Public Health released a survey of adult Iowan’s gambling behaviors and attitudes. This report illustrated that the state’s public health leaders needed to engage key stakeholders in cooperative efforts, including convening these groups for education and prevention programs.

“The work doesn’t start and end with the treatment providers who are only focused on clients with a gambling disorder. It also includes treatment providers who have patients with substance use disorders, Department of Justice personnel and other community mental and public health organizations who see this issue played out among their clients,” Vander Linden said.

The 2011 report also emphasized the need to highlight resources for those who want to learn how to gamble responsibly. The Iowa Gambling Treatment Program’s website,, houses information about tips for responsible gaming and includes a budget calculator to understand how much a person can potentially lose when gambling, based on the odds of a particular game. Website visitors also can find a guideline of what to expect if someone should call the 1-800- BETS-OFF helpline. In addition to its website, the Iowa Gambling Treatment Program created a YouTube channel with short videos explaining the many resources it offers.

For more information, visit the Iowa Gambling Treatment Program’s website or YouTube channel at Vander Linden also will present at the 13th annual NCRG Conference on Gambling and Addiction about the Iowa Department of Public Health’s efforts to implement recovery-oriented systems of care. For more informationon that event, please

This profile of Mark Vander Linden and the Iowa Gambling Treatment Program was originally published in the summer 2012 edition of Responsible Gaming Quarterly. To read or download a full copy of this issue, you can visit theNCRG website.

NCRG staffICRG Newsgambling disordersIowaresponsible gamingtreatment